Chen Jiao, Wang Juan, Wang Zhongwen, Huang Mei, Luo Meixiang, Cai Yanyu
Xiangtan Central Hospital General Department, Xiangtan, Changsha, China.
Xiangtan Central Hospital Nursing Department, Xiangtan, Changsha, China.
Medicine (Baltimore). 2025 May 9;104(19):e42138. doi: 10.1097/MD.0000000000042138.
This study aimed to evaluate the tripartite linkage nursing model's effectiveness in prediabetic patients at risk of type 2 diabetes mellitus, assessing its impact on glycemic control, metabolic outcomes, diabetes prevention, and treatment adherence. In this retrospective cohort study, 400 patients (2020-2022) were allocated via medical record review to control (standard care) and experimental groups (tripartite model integrating hospital-community-home management). Clinical parameters (fasting plasma glucose, 2-hour postprandial glucose, glycated hemoglobin, body mass index, lipid profiles, blood pressure) were monitored at baseline and 6-month intervals over 24 months, with diabetes incidence and adherence rates concurrently evaluated. The experimental group demonstrated superior outcomes: fasting plasma glucose (5.8 ± 0.4 vs 6.3 ± 0.5 mmol/L, P < .01), 2-hour postprandial glucose (7.2 ± 0.6 vs 8.1 ± 0.7 mmol/L, P < .01), and glycated hemoglobin (5.9 ± 0.3% vs 6.4 ± 0.4%, P < .01) showed significant improvements versus controls. Metabolic benefits included reduced body mass index (24.1 ± 2.1 vs 26.3 ± 2.4 kg/m²), optimized lipids (low-density lipoprotein cholesterol: 2.4 ± 0.3 vs 2.9 ± 0.4; triglycerides: 1.3 ± 0.2 vs 1.7 ± 0.3 mmol/L), and blood pressure control (124 ± 8/78 ± 5 vs 131 ± 10/83 ± 6 mm Hg, P < .05). Notably, diabetes incidence decreased by 50% (7.5% vs 15.0%, P = .008) with higher adherence rates (88.4% vs 72.6%, P < .001), confirming dual efficacy in biological and behavioral outcomes. The tripartite model effectively reduces glycemic levels, improves metabolic indicators, lowers diabetes incidence, and enhances compliance, demonstrating significant clinical value for early diabetes prevention and management.
本研究旨在评估三方联动护理模式对有2型糖尿病风险的糖尿病前期患者的有效性,评估其对血糖控制、代谢指标、糖尿病预防及治疗依从性的影响。在这项回顾性队列研究中,通过病历审查将400例患者(2020 - 2022年)分为对照组(标准护理)和试验组(整合医院 - 社区 - 家庭管理的三方模式)。在基线时及之后24个月内每6个月监测临床参数(空腹血糖、餐后2小时血糖、糖化血红蛋白、体重指数、血脂谱、血压),同时评估糖尿病发病率和依从率。试验组显示出更好的结果:空腹血糖(5.8±0.4 vs 6.3±0.5 mmol/L,P <.01)、餐后2小时血糖(7.2±0.6 vs 8.1±0.7 mmol/L,P <.01)和糖化血红蛋白(5.9±0.3% vs 6.4±0.4%,P <.01)与对照组相比有显著改善。代谢方面的益处包括体重指数降低(24.1±2.1 vs 26.3±2.4 kg/m²)、血脂优化(低密度脂蛋白胆固醇:2.4±0.3 vs 2.9±0.4;甘油三酯:1.3±0.2 vs 1.7±0.3 mmol/L)以及血压得到控制(124±8/78±5 vs 131±10/83±6 mmHg,P <.05)。值得注意的是,糖尿病发病率降低了50%(7.5% vs 15.0%,P =.008),依从率更高(88.4% vs 72.6%,P <.001),证实了在生物学和行为学结果方面的双重疗效。三方模式有效降低血糖水平,改善代谢指标,降低糖尿病发病率并提高依从性,对早期糖尿病预防和管理具有显著的临床价值。